Pretravel preparation and travel-related morbidity in patients with inflammatory bowel disease

Background: There are no published data on health preparation and travel-related morbidity in patients with inflammatory bowel disease (IBD).

Methods: A retrospective web-based questionnaire study on past travel experiences with more detailed questions concerning the most recent journey. Participants were recruited from the IBD outpatient clinic and via the website of the Dutch patient organization.

Results: In all, 277 patients who had traveled abroad during the past 5 years (172 Crohn's disease, 105 ulcerative colitis) filled out the questionnaire. The majority (62%) answered that IBD limited their choice of travel destinations. Forty-three percent traveled to resource-limited destinations and 76% thereof obtained pretravel advice. Only 48% were prescribed an antibiotic for self-treatment in case of infectious diarrhea, and 23% were not protected against hepatitis A. Fecal urgency and incontinence were the main IBD-related inconveniences. Thirty-two percent reported a new episode of diarrhea and 28% thereof attributed it to an enteric infection. In total, 15/277 (5%) consulted a foreign physician, of whom five were admitted to hospital. Fifty-four (19%) had a self-reported exacerbation of IBD within 2 months following travel and 24% thereof attributed it to the recent travel. The Mantel-Haenszel odds ratio for an exacerbation within a 2-month period after travel was 1.1 (95% confidence interval [CI] 0.7-1.8) when the number of self-reported exacerbations in a 5-year period was used as reference and 1.5 (95% CI 0.9-2.6) when the year 2008 was used as reference.

Conclusions: Pretravel advice for IBD patients was often deficient. There was a considerable amount of travel-related morbidity and inconvenience.